Basic Information
Provider Information
NPI: 1447224662
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHIMMER
FirstName: RYAN
MiddleName: THOMAS
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6074 S TEMPE WAY
Address2:  
City: CENTENNIAL
State: CO
PostalCode: 800154571
CountryCode: US
TelephoneNumber: 3036996209
FaxNumber:  
Practice Location
Address1: 1055 CLERMONT ST
Address2: DENVER VA MEDICAL CENTER (119)
City: DENVER
State: CO
PostalCode: 802203808
CountryCode: US
TelephoneNumber: 3033998020
FaxNumber: 3033934624
Other Information
ProviderEnumerationDate: 02/14/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P1200X16994COY Pharmacy Service ProvidersPharmacistPharmacotherapy

No ID Information.


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